CLEVELAND — So now we have a new president — a Democratic one – and a Democratic majority in both the House and Senate – but not a filibuster-proof one – and everyone attending this year's Cleveland Clinic Medical Innovation Summit wondered what that will mean for the industry that many have staked their livelihoods to.

An expert panel took a shot at divining the political tea leaves and providing the meeting attendees a valuable primer on what to expect in this new era.

Panel chair Charlie Cook, publisher of the Washington-based Cook Political Report, likened trying to process all the new information coming out after an election to "drinking water out of a fire hose. There's just so much data coming at you that it's hard to digest."

Cook noted that the recent election is a very complex and nuanced one with great policy consequences. He also pointed out that whatever President elect Barack Obama's initial policy plans may have been when he first ran for office "it's obviously going to be very different as a result of the recession we're in than what we would have thought just a few months ago."

He said that no matter what, healthcare is still an important part of our economy and the fastest-growing component of our federal budget, so it will have to be addressed. "How do you do that in the midst of a recession? How do you do that with the tax code that we have today?"

Since they did not get a filibuster-proof majority, Cook said that the Democrats are going to have to "reach across the aisle" in order to pass any truly meaningful legislation and reach beyond their more liberal political base.

Glen Bolger, a partner at Public Opinion Strategies (Alexandria, Virginia), noted that while the economy took center stage in the last few months leading up to the election, healthcare still "fit into the larger motif of we want change in this country.'"

Bolger concurred with Cook's assessment that the Democrats definitely have an advantage, but they cannot "overreach" in setting their political agenda, not only because they don't quite have the political capital do so, but because Independent voters, who are largely responsible for their rise in power this year, won't stand for radicalism of any sort in Washington for very long. He noted that more than 70% of these Independent voters like their current healthcare plan, but 25% of them realize that not everyone has an ideal situation.

"The challenge that any new healthcare policy faces is Look, we have to do something, but don't change what I've got — change what's bad for other people.'"

Chris Jennings, president of Jennings Policy Strategies (Washington), and former senior healthcare advisor to President Bill Clinton at the Domestic Policy and National Economic councils, challenged the assumption that nothing significant will get done on healthcare in 2009 because of the tough economic issues that will be facing this country and lawmakers.

Jennings noted that a recent poll that asked people to rank their greatest economic concerns showed that healthcare ranked above gas prices and job loss. It is a vey big concern for people, especially since it continues to become more and more unaffordable. "You cannot continually have your health insurance premiums increase at three times the amount of your wages and say this is not a problem, and that is what is happening in this country."

Another important factor that may be fueling a greater since of urgency to have a healthcare debate sooner rather than later is that businesses in this country say they cannot compete here and abroad due to these soaring healthcare costs. "They have concluded that they can't [manage healthcare] independent of some collaboration with the federal government, that predominantly regulates and helps finance private coverage under certain rules."

Since the national economy is heavily weighed down by healthcare costs, the costs of standing by will also be unpalatable to Washington, Jennings said. "If we do nothing over the next 10 years, we will see our current $2 trillion deficit in healthcare increase to over $4 trillion."

He believes policymakers will be forced to modernize the healthcare system and make it more efficient, "with a very significant emphasis on quality and value."

As they are doing this, he said that they also will be working to provide healthcare insurance to all Americans. He said that there is no way that healthcare costs in this country will ever be reined in "if we continue to have almost 50 million people outside the system."

According to Jennings, the talk has been about a multi-tiered healthcare system in the future, and he believes that is what Obama supports, and not the single-payer system that so many people in this country fear will happen with the Democrats in power. He said the desire is for everyone to have a chance to get healthcare and for insurance companies to be competing on "price and quality rather than risk selection."

He argued that we will never have a single-payer system in the U.S. "This country will never have Canada or England [style healthcare systems], we will have something that is uniquely American."

He said that what we really need in this country is "appropriate utilization of healthcare," meaning that in some cases one would want higher co-payments to constrain some technology and in other instances one would want these payments to be lower to encourage broader utilization of more efficient and effective technologies and medicines.

Jennings cautioned attendees to not sit around and wait to see what happens. "Always be prepared. Whether you think it's going to be a broad reform or a small reform, there's going to be a change in healthcare. Costs actually demand that we respond and everyone in this room should be prepared for that."

Tim Ring, CEO of C.R. Bard (Murray Hill, New Jersey), used his time to do an interactive poll with the audience.

The first question he asked was whether fundamental healthcare reform would be a top priority for an Obama administration, to which an overwhelming majority responded in the affirmative.

While most respondents agreed it would be a priority, the next question, which asked whether or not any meaningful healthcare legislation would be passed during the 111th session of Congress, drew an overwhelming "nay."

Another query Ring made asked whether the FDA process would become more lengthy and complex in the future, with another overwhelmingly affirmative response.

He also asked whether the audience believed that FDA enforcement and compliance would increase in the near future, and when faced with another overwhelmingly affirmative response, said that from his experience running a device company and from meeting with other companies in the space at meetings that "it's fairly clear and almost across the board that it already has increased over the last three or four years."

Ring said that in today's healthcare market, a company needs to provide proof of the utility of its technology. "If you come out with a new technology, you have to somehow simultaneously demonstrate what the economic benefit is, and that can be a broad-brush approach."

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